华南预防医学 ›› 2014, Vol. 40 ›› Issue (3): 212-216.doi: 10.13217/j.scjpm.2014.0212

• 论著 • 上一篇    下一篇

广州市番禺区流动人口处理医疗缺陷或医疗事故的方式及其影响因素

陈爱如,许桂润2,魏雪灵3,任泽舫3   

  1. 1.广州市番禺区石楼镇社区卫生服务中心,广东 广州 511440;2. 广州市番禺区石楼人民医院;3. 中山大学公共卫生学院
  • 收稿日期:2013-07-27 出版日期:2014-06-20 发布日期:2014-06-13
  • 通讯作者: 任泽舫 E-mail:renzef@mail.sysu.edu.cn
  • 作者简介:陈爱如(1979—),女,大学本科,主管医师,主要研究方向:疾病控制
  • 基金资助:
    广州市番禺区科技计划项目(2012-Z-03-20)

Manners and influential factors of floating population handling medical imperfection or negligence in Panyu District, Guangzhou City

CHEN Ai-ru, XU Gui-run, WEI Xue-ling, REN Ze-fang   

  1. 1. Shilou Town Community Health Service Center, Panyu District, Guangzhou 511440,China;2. Guangzhou Panyu District Shilou People's Hospital;;3. School of Public Health , Sun Yat-sen University
  • Received:2013-07-27 Online:2014-06-20 Published:2014-06-13

摘要: 目的 了解广州市番禺区流动人口在就医过程中处理医疗缺陷或事故的方式及其影响因素。方法 采用分层整群抽样,抽取广州市番禺区石楼镇企业在广州居住满半年以上的非广州市户籍且≥16岁员工进行问卷调查,问卷内容包括调查对象的人口学特征、医疗费用支付方式、对就诊时与医院关系的看法、出现医疗缺陷或医疗事故后做法、索赔情况等内容。对人口学特征及处理医疗缺陷或医疗事故的方式进行描述性流行病学分析,将可能影响患者处理医疗缺陷或医疗事故方式产生的8个因素(年龄、性别、文化程度、婚姻状况、居住时间、月收入、医疗费用支付方式、对就诊时与医院关系的看法)分别作单因素及多因素logistic回归分析。结果 共发放问卷1 370份,有效问卷1 324份,有效应答率为96.64%。其中男性687人,女性637人;以16~45岁的青壮年人口为主(占97.2%,1 287/1 324);70.2%(930/1 324)月收入为1 501~3 000元。调查发现,假如出现医疗缺陷或医疗事故,43.8%(580/1 324)的调查对象表示能谅解,但希望医院道歉并给予减免医疗费用;30.2%(400/1 324)的人表示会通过书面积极投诉讨回公道。对于希望得到什么样的赔偿,60.1%(796/1 324)的调查对象选择参照同一地区同一类纠纷有过的赔偿数额进行索赔,其次是19.0%(251/1 324)希望免除全部的医疗费用。多因素分析结果表明,36~45岁,自费支付医疗费用,月收入为1 501~3 000、≤1 500元,就诊时认为与医院关系为消费者与服务企业关系、合同关系是偏激处理医疗缺陷或医疗事故方式的危险因素(OR调整=1.81,1.92,2.85、2.16,1.94、2.38)。结论 该次调查对象处理医疗事故或医疗缺陷方式主要以理性为主,但仍有部分人趋于偏激,对于流动人口中的中年人群、医疗自费者和低收入人群,医护人员应更加注意与其多沟通交流,并采取相应的防范措施,以有效防止医疗纠纷的产生。

Abstract: Objective To explore manners and influencing factors of the floating population handling medical imperfection or negligence during the process of receiving medical services in Panyu District, Guangzhou City. Methods Subjects were selected by a stratified cluster sampling method from the floating population working in enterprises of Shilou Town, Panyu District, Guangzhou, and having lived there over 6 months, for questionnaire investigation. Contents of the questionnaire included demographic characteristics, payment methods for medical expenses, views on hospital-patient relationship during the visit, manners of handling medical imperfection or negligence, compensation, etc. Descriptive epidemiology method were used to analyze demographic characteristics and manners of handling medical imperfection or negligence. Univariate and multivariate logistic regressions were applied to test eight factors (age, gender, educational background, marital status, length of residence, monthly income, payment methods for medical expenses, and views on hospital-patient relationship during the visiting) probably influencing manners of subjects handing medical imperfection or negligence. Results A total of 1 370 questionnaires were delivered and 1 324 valid ones were recovered, with a response rate of 96.64%. Of the participants, 687 were males and 637 were females, 97.2% (1 287/1 324) of them were aged 16 to 45 years, and 70.2% (930/1 324) had month income from 1 501 to 3 000 Yuan. If medical imperfection or negligence occurred, 43.8% (580/1 324) of respondents chose to be understandable, but want the hospital to apologize and provide a remission of medical expenses; 30.2% of them would actively seek justice by written complaints; for the compensation, 60.1% of them chose to refer to the compensation amount once claimed for the similar dispute in the same area, and 19.0% of them expected to waive all medical expenses. Multivariate logistic regression showed that the subjects aged 36-45 years (OR=1.81), paying medical fees at their own expenses (OR=1.92), monthly income at 1 501-3 000(OR=2.85) and 1 500 Yuan or below (OR=2.16), and considering the hospital-patient relationship to be consumer-service relationship (OR=1.94), or contractual relationship (OR=2.38) were risk factors of handling medical imperfection or negligence in extreme manners. Conclusion Most floating people in Panyu District, Guangzhou would take rational manner to handle medical imperfection or negligence, but some would tend to deal with it in an extreme manner. Medical practitioners should pay more attention to communicating with the floating people at middle age, self-paying medical fees, and low income to prevent medical disputes.

中图分类号: 

  • R197.3